AimsThriving on the pressure of “publish or perish” experienced by academicians, the industry of predatory publishers with dubious quality has mushroomed and gained their notoriety. The battle of uncovering predatory publishers, including Beall's list, has proven to be tough given the huge monetary gain generated by the predatory publishers. It may be difficult for an inexperienced junior researcher to identify those predatory publishers’ soliciting emails, which may disguise as a reputable journal's article-commissioning process. To date, there is a limited systematic approach to identify such emails. Hence, this research is aimed to describe the common features of soliciting emails from publishers which appeared to be predatory.MethodThis self-study involved reviewing the content of emails in the spam folder of authors, a team of junior researchers in psychiatry, for a month. Emails included in this study were soliciting emails relevant to publications and the following were reviewed: types of solicitation, sentences used, strategies used, and information available in the public domain of their webpages. Informative types of emails were excluded.ResultThe solicitation could include: 1) request for a manuscript to be published a journal article, 2) request for a thesis to be published as a book, 3) request to write for a book chapter, 4) invitation to be an editorial member or a reviewer with the offer of free publishing, 5) invitation to be a speaker for a conference, and 6) proofreading services. The publisher may cite a published article of the author from another journal, which was the source where they identified the author's email. Common strategies used for solicitation included: 1) promising a fast-tracked and guaranteed publication, 2) using compliments that appeared to be inappropriate, 3) repetitive emails, and 4) using argumentum ad passiones to induce guilt. The common features of the webpages of those publishers included: 1) open access publishing as the only option, 2) extensive list of indexing services excluding well-established indexing agencies, and 3) the publisher has a huge collection of journals in different disciplines.ConclusionIt is hoped that these findings will help junior researchers in psychiatry to stay vigilant to avoid falling into the trap of predatory publishers, which may result in financial loss and loss of work to plagiarism. Total eradication of those predatory soliciting emails is unlikely despite the advancement of spam filtering technology, which necessitates a more united effort from different stakeholders to come out with a probable solution.

AimsMeasure compliance with National Institute for Health and Care Excellence (NICE) recommendations in four Adult CMHT'sGuide further service development.We audited the case notes of 20 patients each currently under care of 9 General Adult Consultants across 6 CMHT's in East side of North Wales against NICE standards using an adapted version of the ADHD audit support tool.My role in the Project & How does this represent my practice?I was the audit and overall lead for this projectI formulated the audit tool and registered my project with Audit Registration Team.I lead data collection and compilation of results.MethodOverall, this is the first audit of Adult ADHD Services in East side of North Wales.It established good compliance with NICE guidance for assessment and treatment.NICE has expressed the need for full mental health and social assessment including full history and physical examination prior to the drug treatment.Good compliance was observed in using & documenting Diagnostic Criteria (DSM-IV and/or ICD-10).There were deficiencies in conducting or arranging recommended physical examination & side effect monitoring.Drug treatment was the first line of treatment in the majority of cases.Antipsychotics were used in some patients referred for ADHD assessment, despite the fact that NICE has ruled out the use of antipsychotic drugs in treatment of core symptoms of ADHD.ResultPrevalence of Adult ADHD clinician case load in Wrexham and Fintshire Counties.Diagnosis of Adult ADHD according to ICD 10 & DSM IV Guidelines.Pre treatment screening of physical health for ADHD patients.Side effects monitoring of patients on stimulant medications.ConclusionThe finding highlights the need for more effort in educating clinicians about safety and effectiveness of antipsychotics in ADHD.Comprehensive treatment programmes that address psychological, behavioural, educational and occupational needs should be established.Development of local ADHD Clinics, support groups and in partnership with the voluntary sector should be encouraged.It is important that mental health professionals receive appropriate training in assessment, management & monitoring of ADHD patients with co morbid substance use disorder and other mental illnesses.BETSI Health Board to participate in national Prescribing Observatory for Mental Health (POMH-UK) Quality Improvement Programme (QIP) focusing on prescribing for ADHD in children, adolescents & adults.

AimsBringing specialist psychiatrist into PCMHTUndertaking initial assessments for people Referred by G.P'sWorking According to the principle of “Prescribing Interventions”Decrease number of assessments carried out within secondary CareMethodCounty of Wrexham is situated between the lower Dee Valley and the Welsh mountains. It is the largest town in North Wales (140,000)Since 2013, the total new patient referrals to be seen by Wrexham county consultant psychiatrists has consistently risenThis issue has been dealt with in different ways across North Wales and indeed the whole of WalesFollowing a review of services in Wrexham during 2017, it was identified that there was an opportunity to pilot a new model which would allocate a designated Consultant to the local Primary Care Mental Health Team (PCMHT)The Consultant would work entirely within Part 1 of the Mental Health Measure and would offer specialist opinions to Tier 1 ServicesResultPCMHT team members are maintaining open cases for a significant amount of time rather than the 8–10 sessions that was originally predicted during the implementation of the Mental Health MeasuresIn order to sustain the service, the minimum number of direct clinical patient contact sessions to be offered by the psychiatrist was up to 4 a week.During the review period, total number of clinics offered were 51 and a total of 139 patients were offered appointmentsConsultants in secondary care covering the same area received exactly 100 less referrals in the first 6 months of the pilotMain source of referrals to the Tier 1 Consultant came from G.P.'s and the local PCMHT itselfConclusionPilot demonstrated that bringing specialist consultant psychiatrist dedicated to the PCMHT improved the care offered to patients referred by G.P'sScope of PCMHT needs to extend in order to absorb mild to moderate mental illness and thus avoid patients going into secondary careThis model should be supported, and further resources should be inputted into PCMHTWe should move from a categorical diagnostic referral system to a needs-based intervention where only the most complex cases requiring lengthy interventions shall progress to secondary careRisk should not be classed as criteria to move patients into secondary care and PCMHT should be able to absorb moderately risky cases

AimsThere is a significant period of adjustment for new higher trainees in psychiatry given the presence of inter-trust differences in the National Health Services (NHS). It may take some time for a trainee to become familiar with the new administrative system and workflow of the new environment, which may be even longer for an international medical graduate (IMG). Although there is an existing induction system, having a written structured manual will assist the trainees to get through this process more easily. Hence, this Quality Improvement Project (QIP) outlined the creation of an induction manual that serves as a starter pack to facilitate the settling-in process of new North Wales higher trainees in psychiatry, i.e. the “Croeso i Seiciatreg Gogledd Cymru” (CiSGC) guide (means Welcome to North Wales Psychiatry in Welsh).MethodThe induction manual was initially drafted by the authors based on the available printed policies and information online. Further input and from different stakeholders were obtained to triangulate and enrich the manual. Specific links and further references were included in the manual for the reference of prospective manual users. Authors’ contact details were included for any further clarification, suggestions or input.ResultThe manual consisted of four sections: A) General Process before, during and after Reporting Duty, B) Trainees’ Duty, 3) Speciality-specific Guidance, and 4) Health Board-related Information. The General Process section covered the visa-related information, post-acceptance paperwork process, access to email and hospital informative system, medical practice-related issues (including section 12(2) approval and medical indemnity). The Trainees’ Duty section briefed on time-tabling and clinical duty. The Specialty-specific Guide provided important information related to training. Lastly, the section of Health Board-related Information highlighted the administrative structure of the NHS Health Board, important contact numbers, link to information. Specialty specific sections were created for general adult psychiatry and old age psychiatry as there is no other higher training of psychiatry in North Wales at the moment. Further sections in the pipeline include substance misuse and liaison psychiatry.ConclusionThis induction manual is neither prescriptive nor exhaustive. It serves as a generic reference to facilitate new trainees in their adjustment process. Further review and revision will be conducted before every induction process to ensure the information is up-to-date and incorporating new input from the trainees.

Aims1.Quality of clozapine clinic appointment2.Effectiveness of clozapine clinic servive3.Compliance with BCUHB guidelines for physical health monitoring in clozapine clinics4.We retrospectively audited 40 case notes 10 each from 4 differtent CMHT clozapine clinicsMy role in the Project & How does this represent my practice? 1.I was the audit and overall lead for this project2.I formulated the audit tool and registered my project with Audit Registration Team3.I lead data collection and compilation of resultsBackground1.This audit followed up from a Coroner's investigation for a clozapine clinic patient2.Clozapine is used for Treatment Resistant Schizophrenia but needs close monitoring due to potentially fatal side effects3.NICE recommends annual monitoring of weight, blood pressure, waist measurement, blood glucose and plasma lipid levelsMethod1.Has the patient been seen in the past year by clinician to monitor response to clozapine treatment?2.Has the clozapine plasma level been measured during the last year of treatment?3.Is brief MSE & Risk assessment documented during review?4.Has Life style modification advice been provided?5.Has annual physical health been completed?6.Has Annual CTP/CPA been completed and documented?7.Has the patient been allocated a named care coordinator?8.Has clozapine side effects monitoring been documented?Conclusion1.Clozapine is a superior medication for the treatment of refractory schizophrenia and is also be effective for other conditions2.Clozapine is underused due to a variety of barriers related to the drug and its properties, the health care system & regulatory requirements3.This service evaluation/quality improvement project provides the framework for clozapine clinics evaluation and recommends strategies for improvement